PUBLIC ADMINISTRATION AND DISABILITY IN THE 21ST CENTURY
Julie Ann Racino
Member, Health and Human Services, and Budget and Finance
American Society for Public Administration
March 2018
In 2015, the American Society for Public Administration began a process to inform it membership of the multi-decade efforts to reform institutional to community-based (CBOs) organizations in the US and worldwide. A formation Section on Public Administration and Disability, as an addition to the existing ASPA Chapters and Sections, proposed a series of goals for review by its membership which are highlighted here:
Health and Human Service Goals
1. Disability and Ethnic NGOs and Their Status
2. Academic Education Programs in Public Administration and Disability
versus Public Health and Management
3. Human Services to Community Health or Dual Transitions at Managed Care
/HealthCare Marketplace
4. Individual, Family and Community Health: One Health Concept vs.
Behavioral Health Care
Brief Findings:
I. Disability and ethnic NGOs (e.g., the Arc-US, Hispanic Action League) are separate entities and have expanded in the US and worldwide; ASPA's university public administration departments claim to be primarily the latter, as highlighted by Virginia Commonwealth University's Susan Gooden. ASPA PA departments may be accredited to offer both public administration (MPA) and public health (MPH) degrees.
II. Managed Care is operational in the US, and is not necessarily a preferred management by those governments wishing to achieve universal health care (e.g., health care marketplaces). Managed Long Term Services and Supports (MLTSS) is not the same as LTSS (Long Term Services and Supports).
III. ASPA's Journal of Health and Human Services Administration published an ecological concept of community in line with individual, family and community health, but the expansion of government funds is heavily behavioral health care. The concern with the latter is its use with involuntary care and its expansion in US and globally.
Environmental Goals
1. Conversion to Green and Sustainable Government and Contracting Agencies
2. Support of Global Change and Local Environmental Concerns
3. Prevention, Health Promotion, Resiliency, Community Support and Wellness
Brief Findings:
I. ASPA Annual Conference presentations in 2016 and 2017 highlighted sustainability in community and economic development, and ASPA held sessions for its personnel on rules in government contract and procurement. Local and State Government Review held ASPA presentation and discussion sessions.
II. The PA Times in 2017 highlighted by ASPA president Alan Rosenbaum, the Sustainable Development Goals (SDGs) and the contributions of public administration toward a better environment and world.
III. A resurgence of the concept of resiliency ("bounceback"), new institutes in health promotion, and prevention in the traditional public health concepts (e.g., "tobacco cessation", "disease eradication") were still the most popular concepts with alternative medicine (e.g., "wellness" through yoga, fitness, health bonuses for healthy habits) and community support (at NGO woman CEOs) being overshadowed by other concerns such as community policing in the 21st century.
Budget and Finance Goals
1. Health Care and Community Financing
2. State Categorical Service Systems, Government Personnel, and Contracting
3. Governmental Programs: Medicaid, Medicare, Social Security and Social Security Disability
4. Individual and Family, Consumer-Controlled Budgets
Brief Findings:
I. Julie Ann Racino presented at the 2015 ASPA Annual Conference on Health Care Financing and its Growth in the Community (with William Rivenbank). Presentations of Employment First and its Relationship to Cultural Diversity were held with Sanjay Panday and ASPA universities by Allan Bergman and Julie Ann Racino in Seattle, Washington.
II. ASPA highlighted the federal departments with the new US Centers for Medicaid and Medicare visible as a governmental administration. The federal government itself has been entertaining proposals to privatize Medicaid and Medicare (not advised by this party; similar proposals to privatize jails and prison systems) and a new Supplement on Medicaid and Medicare was published in Public Administration Review.
III. Cash for Care (privatization health care schemes) international edited book is now available, in addition to books on direct payments, family policies worldwide, encyclopedia entries in direct payments and user-directed personal assistance, new person-directed conversion plans in Europe and Australia, and laws in Europe on employment support allowances (the latter reported as newly attacked by the elective governments).
IV. Association for Budgeting and Management (ABFM) is affiliated with ASPA and holds its own Annual Conference with a community orientation to the budget and personnel; the definition of community is the "pre-1970s" one which includes 100-bed private, nursing facilities (no, at forced hospitalization), new assisted living on private, non-profit campuses, "side by side buildings" (educational facilities in disability), rehabilitation and correctional facilities as community.
V. New US Personnel Administration book by ASPA members which updates through the President Barack Obama federal administration. Literature reviews indicated earlier federal outsourcing as part of federal downsizing and major changes in the US and state civil service systems (public servants).
Inclusion and Empowerment Goals
1. United Nation's Convention on the Rights of Persons with Disabilities (2006) now cojoined with the UN Convention on the Rights of the Child (2018, UN debates)
2. Deinstitutionalization, Smart Growth, and Community Development
3. Community Participation, Inclusion and Empowerment: Principles and Theories of Families, Independent and Supportive Living, Person-Centered and Employment First
Brief Findings:
I. United Nations, located in New York City, continues to be a hotbed of international action with the new administration and its US Ambassador at the UN Security Council (devastating war in Syria, landmines in Ukraine), human rights reviews by international bodies, International Day of Persons with Disabilities (and UN disability groups), and Ministerial Leadership Speeches, Votes and Actions from the environment to "new world visions" (from the world order, now UN web tv).
II. Julie Ann Racino presented at NeCopa on the State of the Science in Deinstitutionalization in 2017, US-UK relationships in government and public policy, and Community Integration and Inclusion Studies over 40 years (courtesy, leadership Douglas Biklen and the Center on Human Policy, Schools of Education). Mathematica, a private research firm, indicated plans in 2016 for reallocation of community financing varying from the US State of the States in Intellectual and Developmental Disabilities (Braddock, Hemp, et al, 2015).
III. Smart growth and transportation with Transportation America, and Policy Link (excellent, ethnic base, national conferences) represent new national organizations that are represented in America's new urban growth, in the development of modernization of transportation infrastructure, and in plans for pedestrian and bike trails to curb the automobile pollution in the US. Housing panels were featured in Atlanta, Georgia and Seattle, Washington with new government initiatives to address escalating housing costs, support services and homelessness.
IV. President Barack Obama began the National Institute on Independent Living and Rehabilitation Research (NIDILRR) in the US Department of Health and Human Services Administration in Department of Community Living. Other national institutes, such as those in US Department of Education (e.g., National Institute on Disability Research and Rehabilitation) or US DHHS (e.g., National Institute on Mental Health) continue to provide leadership for national initiatives.
Personnel Goals
1. Compliance with the Americans with Disabilities and Individuals with Disabilities Education Improvement Act
2. Development of the US Direct Professional Workforce for the Government Sectors (and Non-and-For-Profit)
3. Meeting Direct Service Needs of Individuals and Families (e.g., Support and Respite Aides, Specialized Child Care)
Brief Findings:
I. The education and disability systems are very actively involved with passage of current laws and funding opportunities (e.g., President Barack Obama and funding for housing and HIV-AIDS); on the 1970s standards, ASPA itself (and the court systems themselves) is out of compliance on integration standards (e.g., active Architectural Access Compliance Board). Historic videos online (C-SPAN-3) on the Education of Handicapped Children's Act of 1974 with Judith Heumann, cofounder of World Institute on Disability (See, Joan Leon, 2018).
II. New efforts to address the US telephone relay system for the deaf and hard of hearing, and taken-for-granted hearing exams for "newborns"; and to make available expanded opportunities for individuals with blindness (including US taken-for-granted cataract surgery which easily and effectively corrects partial blindness). Health care plans on state exchanges may also be packages for cancer treatments or HIV-AIDS planning.
II. The US Direct Professional Workforce (Racino, 2000; Larson et al, 2012) "exited again" as "multiple nationals" intellectual and developmental disabilities, separating from an integrated workforce across state departments and voluntary associations. CCD (Consortium of Citizens with Disabilities) still represents mixed voluntary associations in Washington, DC (e.g., now Autism and Family Support). ASPA members Julie Ann Racino, Allan Bergman, and National Council Members Andrea Huston and Stephen Rolandi were given the prison reform in intellectual and developmental disabilities in 2017.
III. The new "Behavioral Health Care" became the new term for the personnel related to "substance abuse and mental health" (SA/MH), one of 9 categories of "behavioral health practitioners" (new management groups). Sherri Larson was a behavioral aide early in her own career (Larson in Racino, 2014), and my colleague K. Charlie Lakin's (Lakin & Racino, 1990) IMPACT is based upon the generic "Support and Inclusion Workforces" of Syracuse University with "behavioral multi-decade overlays" in other journals (University of Minnesota).
IV. More information forthcoming with a major concern its relationship to mass incarceration and growth in corrections workforces and increased budgets devoted to these sectors (being transferred to criminal justice control -"Education reporting"). For example, yesterday (March 5, 2017), new NYS penal law revisions "effective immediately" with televised coverage and "no laws to the viewers".
V. Thank you for the new books in 2012 (e.g., Carl Dunst and George Singer, our colleagues from the 1980s science centers and universities) and articles (e.g., Chris Hatton, UK on respite; Sherri Larson on specialized aides) which described early childhood, early intervention, early family support, user-directed services, "federal approved" aides, and family approaches to young children and their futures.
VI. Schools of Education continue to operate separately from Schools of Public Administration for the most part, for example awarding dual inclusion education degrees (with allowances for work in mental health, private practices).
Public Policy and Disability Goals
1. Comprehensive and transparent public policy and public policy and human development
2. Development of public administration and disability workforces in the community
3. Public administration and disability: Comparative approaches in the international sector
Brief Findings:
I. Transparency was a primary goal of the Obama Administration, and human development, a hallmark of the Urie Brofenbrenner age has now a new mental health and corrections education "cohort" of Ph.D.s and MDs (e.g., School of Human Ecology, Cornell Weil Medical Center in New York) together with a new undergraduate psychology (e.g., decade of the brain). Thank you to John Eckenrode, immediate past Director and Pat Thayer of the Urie Brofenbrenner Translational Center.
II. ASPA will continue with leadership in non-profit governance which will affect the future of other non-profit industries in the US and globally, and vice versa. The roles of governments will continue to change in a post-911 era in which defense budgets have escalated over health and human services, with the latter also escalating beyond the budgets of Americans. ASPA does not have a workforce termed disability per se or for that matter, public administration and rehabilitation, though the US Direct Support Workforce (Larson, et al, 2014 in Racino, 2014; Brandt to Trump, 2018) falls under the Nonprofit Governance Section, "Women in Government", Science and Technology, Minority Administration, and Health and Human Services Administration.
III. International sectors and associations continue to be "robust sectors of the economies" and will continue to develop as a distinct sector "from or as governments" in the coming decades. The third sector voluntaries, became literature prominent and include expansive growth in "gender organizations and goals" which are reaching tipping points in personnel in the 21st century.
IV. State departments are seldom addressed in the literature, other than as one department (e.g., NYS Office of People with Developmental Disabilities); and state departments tend to keep their own reports and archives in government. Federal departments and their reorganizations continued to be reviewed in 2017 (Racino, NeCopa, 2017, e.g., "partial reorganization" of HEW to US DHHS) with an organizational chart describing Administration on Children and Families in Racino, 2014. Julie Ann Racino offers an introduction in her book, Public Administration and Disability: Community Services Administration in the US (Racino, 2014) at http://www.crcpress.com/authors.
For more information, please feel free to contact Julie Ann Racino, via ASPA in Washington, DC at the Main Office, 1730 Rhode Island Ave., NW, Suite 500, Washington, DC 20036; the author resides in Rome, New York.
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